<div dir="ltr">
<div id="gmail-toolbar" class="gmail-toolbar-container">
</div><div class="gmail-container" dir="ltr">
<div class="gmail-header gmail-reader-header gmail-reader-show-element">
<font size="1"><a href="https://theintercept.com/2020/12/31/covid-vaccine-countries-scarcity-access/">https://theintercept.com/2020/12/31/covid-vaccine-countries-scarcity-access/</a>
</font><h1 class="gmail-reader-title">World Faces Covid-19 “Vaccine Apartheid”</h1>
<div class="gmail-credits gmail-reader-credits">Sharon Lerner - December 31, 2020<br></div></div><hr><div class="gmail-content">
<div class="gmail-moz-reader-content gmail-reader-show-element"><div id="gmail-readability-page-1" class="gmail-page"><div><div><p><u>Pfizer CEO Albert Bourla</u> recently heaped praise on “the almost 44,000 people who selflessly raised their hands to participate in our trial.”</p>
<p>“Each of you has helped to bring the world one step closer to our
shared goal of a potential vaccine to fight this devastating pandemic,”
Bourla wrote in an <a href="https://www.pfizer.com/news/hot-topics/a_letter_to_our_trial_participants">open letter</a>
to volunteers who took part in Pfizer’s Covid-19 vaccine research,
which was conducted in Argentina, South Africa, Brazil, Germany, and
Turkey as well as the U.S. His letter was published on November 9, the
same day Pfizer announced that the vaccine was more than 90 percent
effective at preventing the disease, and Bourla laid this considerable
accomplishment at the feet of the medical volunteers: “You are the true
heroes, and the whole world owes you a tremendous debt of gratitude.”</p>
<p>But Argentina, South Africa, Brazil, and Turkey will have to be satisfied with Pfizer’s gratitude, because (like <a href="https://app.powerbi.com/view?r=eyJrIjoiNmE0YjZiNzUtZjk2OS00ZTg4LThlMzMtNTRhNzE0NzA4YmZlIiwidCI6Ijc3NDEwMTk1LTE0ZTEtNGZiOC05MDRiLWFiMTg5MjAyMzY2NyIsImMiOjh9&pageName=ReportSectiona329b3eafd86059a947b">most countries in the world</a>) they won’t be receiving enough of the vaccine to inoculate their populations, at least not anytime soon.</p>
<p>Meanwhile, the U.S. and Germany — along with Canada and the rest of
the European Union — have contracted for enough doses of various
Covid-19 vaccines to inoculate their populations <a href="https://www.nytimes.com/2020/12/15/us/coronavirus-vaccine-doses-reserved.html">several times over</a>. While the U.S. is <a href="https://www.nytimes.com/2020/12/30/health/covid-vaccines-slow-rollout.html" target="_blank">struggling</a> with the logistics of its vaccine rollout — fewer than <a href="https://covid.cdc.gov/covid-data-tracker/#vaccinations" target="_blank" rel="noopener noreferrer">3 million</a> people
have received the first dose so far — adequate supplies should
eventually be available. The U.S. pre-purchased 100 million doses of the
Pfizer vaccine for $1.95 billion in the summer (and reportedly <a href="https://www.nytimes.com/2020/12/07/us/politics/trump-pfizer-coronavirus-vaccine.html">passed</a> on the opportunity to secure another 100 million doses). Last week, the Department of Health and Human Services announced a <a href="https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-supply-us-100-million-additional-doses">deal</a>
to buy another 100 million doses of the vaccine by July 2021, and the
government has the option to purchase an additional 400 million doses.
The U.S. has also purchased 200 million doses of the Moderna vaccine,
which is also extremely effective against Covid-19. Those doses are due
by the second quarter of 2021, and the government may buy up to 300
million more doses. And the U.S. has contracts for additional vaccine
doses from Ology, Sanofi, Novavax, and Johnson & Johnson, whose
candidates are in earlier stages of development.</p>
</div><div>
<p>Pharmaceutical companies and individual executives are already
profiting handsomely from their medical breakthroughs. On the same day
that he sent his open letter, Bourla, whose net worth is estimated at
more than $26 million, <a href="https://www.cnbc.com/2020/11/11/coronavirus-vaccine-pfizer-ceo-sold-5point6-million-of-stock-as-company-announced-positive-data.html">sold</a>
more than $5 million worth of his shares of Pfizer stock. Pfizer has
already made an estimated $975 million from the vaccine this year and is
expected to earn another $19 billion in revenue from the vaccine in
2021, according to Morgan Stanley. Pfizer’s profit margin on the vaccine
is <a href="https://www.fiercepharma.com/pharma/pfizer-ceo-says-it-s-radical-to-suggest-pharma-should-forgo-profits-covid-19-vaccine-report">estimated</a> at between 60 and 80 percent. Moderna is <a href="https://www.cnn.com/2020/12/11/business/pfizer-vaccine-covid-moderna-revenue/index.html">projected</a> to make more than $10 billion from its vaccine next year.</p></div><div><p><img src="https://theintercept.imgix.net/wp-uploads/sites/1/2020/12/GettyImages-1230192777.jpg?auto=compress%2Cformat&q=90&w=1000&h=638" alt="Picture taken on December 18, 2020 shows a corona vaccination center at the fair grounds in Hamburg, northern Germany, amid the ongoing novel coronavirus / COVID-19 pandemic. - The European Union is facing heavy pressure to approve vaccines after Britain and the United States have already administered tens of thousands of shots while China and Russia have begun efforts with their own vaccines. The bloc intends to start its inoculations with the Pfizer-BioNTech vaccine before the end of the year. (Photo by Axel Heimken / AFP) (Photo by AXEL HEIMKEN/AFP via Getty Images)" style="margin-right: 0px;" width="430" height="274"></p><p class="gmail-caption">A corona vaccination center at the fair grounds in Hamburg, Germany, on Dec. 8, 2020.</p>
<p class="gmail-caption">
Photo: Axel Heimken/AFP/Getty Images</p></div><div><p>The estimated <a href="https://www.fiercepharma.com/pharma/lead-covid-19-vaccine-players-will-split-100b-sales-and-40b-profits-analyst">$100 billion</a>
in sales to be made from a Covid-19 vaccine was clearly part of what
attracted pharmaceutical companies to vaccine research. For the
participants in that research, the calculus is different. In developing
countries, “you find people who don’t have medical care and are
desperate for medical attention and will grasp at the straws of medical
research,” said Harriet Washington, a medical ethicist and author.</p>
</div><blockquote><span></span><p>A
relative lack of oversight and lower operating costs are some of the
reasons that pharmaceutical companies do the majority of their research
in less affluent countries.</p></blockquote><div><p>That
desperation is only part of the reason that pharmaceutical companies do
the majority of their research in less affluent countries, according to
Washington, who pointed to a relative lack of oversight and lower
operating costs as additional reasons that the industry is drawn to
those places. The Covid-19 vaccine research participants in South
Africa, Argentina, Brazil, and Turkey “will work more cheaply than the
people in the U.S. and Germany,” she said.</p>
<p>The ethical problem this creates — that people in developing
countries have less access to medical breakthroughs
despite shouldering a disproportionate share of the risk that enables
their development — far predates the coronavirus pandemic. “There are
inherent inequities that are repeated in every epidemic,” said
Washington. “It’s a consistent pattern; you’ll see it as far back as you
want to go.”</p>
<p>Whether they participate in drug research or not, people in low- and
middle-income countries often lack access to lifesaving medical
breakthroughs, which are sometimes priced out of their reach. Gilead,
which holds the patent on the hepatitis C drug sofosbuvir, has provided a
clear and tragic illustration of how deadly this dynamic can be. Only
about one in seven people who needed the company’s lifesaving drug in
Brazil had received it as of June 2019. In that country alone, thousands
died of the treatable disease, <a href="https://makemedicinesaffordable.org/unprecedented-complaint-to-the-brazilian-antitrust-authority-cade-denounces-abuse-on-hepatitis-c-drug-pricing/">according</a>
to the nonprofit group Make Medicines Affordable. Though many drugs
eventually become available, access is often delayed for people in
developing countries, as was the case for lifesaving HIV medications,
which are still unavailable to some 15 million infected people around
the world and arrived in some poorer countries more than a decade after
they were used in wealthier ones.</p>
<p>“We see lags occur in almost every intervention in the world whether
it’s a new drug or medical device,” said Dr. Krishna Udayakumar,
founding director of the Duke Global Health Innovation Center. “There’s
not as much money in products reaching markets in low- and middle-income
countries.” As a result, in much of the world, access to lifesaving
developments often depends on funding from donors, “which is always less
than you’d like,” he said.</p>
<p>The deadly consequences of delayed access to the Covid-19 vaccine
will be on display in the coming year. The number of people vaccinated
worldwide in 2021 will depend partly on whether other potential vaccines
candidates are successful and whether they’re delivered as <a href="https://globalnews.ca/news/7546507/coronavirus-vaccine-moderna-one-shot-hillier-ontario/">one dose or two</a>. But it’s already clear that the majority of countries will not have enough, while rich countries are <a href="https://www.nature.com/articles/d41586-020-03370-6?fbclid=IwAR09Ea8qcHpjAf9MtnrdJ3RxIGSuXv753dcP8WijYn3IO2jhC3K_5QGFIPc">hoarding</a> vaccine supplies.</p>
</div><p><a href="https://theintercept.com/collections/the-coronavirus-crisis/"><span><span><img alt="The Coronavirus Crisis" src="https://theintercept.imgix.net/wp-uploads/sites/1/2020/03/GettyImages-1206948638-coronavirus-1584129093-promo.jpg?auto=compress%2Cformat&q=90&fit=crop&w=440&h=220" style="margin-right: 0px;" width="430" height="215"></span></span><span><span>Read Our Complete Coverage</span><span>The Coronavirus Crisis</span></span></a></p><p>An international initiative to ensure equitable access to the vaccine, <a href="https://www.gavi.org/vaccineswork/gavi-covax-amc-explained">called</a>
the COVAX Advance Market Commitment and governed by the public-private
health alliance Gavi, aims to provide participating countries with
enough vaccines to inoculate up to 20 percent of their populations by
the end of 2021. But even under the best-case scenario, this goal would
leave the vast majority of the population unvaccinated — and is “subject
to funding availability,” as the group’s <a href="https://www.gavi.org/vaccineswork/covax-explained">website</a> makes clear.</p><div><p><img src="https://theintercept.imgix.net/wp-uploads/sites/1/2020/12/GettyImages-1229305197.jpg?auto=compress%2Cformat&q=90&w=1000&h=667" alt="ANKARA, TURKEY - OCTOBER 27: A health care worker injects the a syringe of the phase 3 vaccine trial, to a volunteer at the Ankara University Ibni Sina Hospital in Ankara, Turkey on October 27, 2020. This vaccine candidate developed against the novel coronavirus (COVID-19) pandemic by the U.S. Pfizer and German BioNTech company. (Photo by Dogukan Keskinkilic/Anadolu Agency via Getty Images)" style="margin-right: 0px;" width="430" height="287"></p><p class="gmail-caption">A
health care worker injects a syringe of the phase 3 vaccine trial, to a
volunteer at the Ankara University Ibni Sina Hospital in Ankara, Turkey
on October 27, 2020.</p>
<p class="gmail-caption">
Photo: Dogukan Keskinkilic/Anadolu Agency/Getty Images</p></div><div><p>Some
international health activists have become frustrated with Gavi. “On
day one, when the first person was vaccinated in the U.K., we should
have been seeing the equivalent in a developing country,” said Kate
Elder, senior vaccines policy adviser for Médecins Sans Frontières. “But
we didn’t. And we don’t have any precision about when we can expect
those doses in developing countries.”</p>
<p>Elder pointed out that, despite its stated goal of providing equal
access, the international vaccine distribution effort is hindered by the
global power and wealth imbalance. “Gavi will never call out vaccine
nationalism because its biggest donors — like the U.K. government — are
the most powerful members of their board,” she said.</p>
</div><blockquote><span></span><p>The international vaccine distribution effort is hindered by the global power and wealth imbalance.</p></blockquote><div><p>The
World Bank is providing additional aid for the delivery of vaccines,
but it is in the form of loans, which poor countries will need to repay.
As a result of the delays, many people in low-income countries will
likely not get the vaccine until 2023 or 2024, which will result in an
unknown number of deaths.</p>
<p>“We’re facing a global vaccine apartheid,” said Zain Rizvi, law and
policy researcher at Public Citizen, who predicted that the delay in
vaccine access will prove “calamitous.”</p>
<p>Public Citizen has <a href="https://www.citizen.org/article/a-plan-for-the-peoples-vaccine/?eType=EmailBlastContent&eId=a01c6630-44f9-4d50-9fb2-b91aed8d8602#_ftn37">proposed</a>
several ways that the U.S. could expand access to the vaccine,
including building new production facilities and taking advantage of an
obscure <a href="https://www.law.cornell.edu/uscode/text/28/1498">statute</a>
that allows the government to override companies’ patents on inventions
they fund. Meanwhile, Kenya, India, and South Africa put forward a
measure at the World Trade Organization that would waive some
intellectual property rights for coronavirus-related products, including
vaccines. The proposal, which was supported by 99 countries, has yet to
pass after being opposed by wealthy countries, including the U.S.,
European Union members, Japan, the U.K., and Australia.</p>
<p>But the waiving of patents is only the first step in ensuring global
access to vaccines. “Know-how is the bigger problem than patent rights
in the shorter run,” said James Love, who directs the nonprofit advocacy
group Knowledge Ecology International. Love pointed to Moderna, the
federally funded vaccine maker that has already <a href="https://investors.modernatx.com/news-releases/news-release-details/statement-moderna-intellectual-property-matters-during-covid-19">pledged</a>
not to enforce the patent on its vaccine. “But you still can’t go out
and make their vaccine unless you know how they did it,” said Love. “You
need to force the people who have the know-how to share the know-how
because it’s a fucking pandemic.”</p></div><div><p>While
the U.S. government and the companies it funded to make vaccines are
already getting credit for ending the pandemic, Love points to a big
hole in that success story: that taxpayers wound up paying for deals
that limited global access.</p>
<p>“Some people are going to say this is a massive success because the
innovation story is pretty good,” said Love. “But the reality is the
government took our money, gave it to the companies, and wrote terrible
contracts so we ended up with very few rights over the inventions that
we financed.”</p>
<p>The problem was entirely avoidable, according to Love. “The
government could have put mandatory sharing of know-how built into each
of its contracts so the technology transfer would have started as soon
as these vaccines were in clinical trials,” he said. “That did not
happen. And one of the consequences of these giveaways is that we’ve
condemned developing countries to delayed access to vaccines.”</p>
</div><div><p>The Trump administration has been particularly <a href="https://theintercept.com/2020/10/23/trump-covid-19-pharma-regeneron-coronavirus-treatment/">generous</a> with the pharmaceutical industry, removing <a href="https://theintercept.com/2020/07/01/coronavirus-treatment-drug-contracts-trump/">standard protections</a>
from some of their contracts, and has shunned international efforts to
pool resources to fight the pandemic. But it’s not too late for the
country to reverse course.</p>
<p>“President-elect Biden has the power to change that,” said Public
Citizen’s Rizvi. “He can think bigger and share the vaccine recipe and
help ramp up production and manufacturing capacity to further expand
vaccine supply quickly.”</p>
<p>The ethical dilemmas raised by conducting Covid-19 vaccine research
in countries that may not have their own supply for years are fixable
too, according to Washington. “The inequities are easy to address,” she
said. “You simply treat people in the developing world the same way you
treat everyone else.”</p></div></div></div></div>
</div>
<div>
</div>
</div>
</div>